To stop Ebola, go to the source

THE sheer scale of human suffering in West Africa in relation to the Ebola Outbreak is spelled out in black and white with the current numbers from the World Health Organization (WHO). As at 8 October, 4,032 fatalities have been recorded, with Liberia recording the highest thus far with 2,316; 930, in Sierra Leone, 778, in Guinea and 8 in Nigeria this year. Its been spoken of over and over again; the subregion’s Ebola outbreak is the world’s deadliest to date and the WHO has declared an international health emergency. Apparently, many rural communities in Africa view Ebola with much the same fear and misunderstanding as westerners did when the AIDS epidemic began, and have sometimes turned on overstretched health officials struggling to contain the epidemic.

Those on the frontlines have been among the hardest hit by the disease. Ebola is a viral illness of which the initial symptoms can include a sudden fever, intense weakness, muscle pain and a sore throat. Subsequent stages are vomiting, diarrhea and – in some cases – both internal and external bleeding. The disease infects humans through close contact with infected animals, including chimpanzees, fruit bats and forest antelope. It spreads between humans by direct contact with infected blood, bodily fluids or organs, or indirectly through contact with contaminated environments. Even funerals of Ebola victims can be a risk, if mourners have direct contact with the body of the deceased. The incubation period can last from two days to three weeks and it should be known that the current outbreak is the deadliest since Ebola was discovered in 1976. On August 8, the WHO declared the outbreak a Public Health Emergency of International Concern.

As the Ebola outbreak is currently underway in several West Africa countries, exponentially rising in Liberia, Sierra Leone and Guinea, surely and widely, the epidemic continues to grow and spread into new areas, threatening more lives and potentially the economies of affected countries. The statistics from the WHO are particularly grim especially when looking at the rate of new cases over the past month. In Guinea, Liberia and Sierra Leone alone, nearly 2,800 new infections have been recorded. That’s about a third of all Ebola cases- an indication the virus is spreading at a faster rate than previously. In Liberia alone, the Ebola epidemic is insidiously decimating the population of the country and social and economic life there is literarily on a “standstill”.

The situation there is so severe and gloomy that the President, Ellen Johnson-Sirleaf, had to declare a state of emergency in August, as the country continues to grapple with the outbreak of the deadly Ebola virus. The state of emergency included ordering the closure of schools and markets and the quarantining of affected communities, in an attempt to halt the Ebola epidemic. The spread has also been overwhelming health workers and health facilities, with reports that doctors were forced to turn patients away at one of Liberia’s main Ebola isolation wards in a sign many were belatedly coming forward.

The Ebola epidemic has also effectively crippled the country’s economy due to the “lockdown” as most economic activities are virtually non-existent. The same gloominess and ominousness applies to other affected countries across the West African sub-region. This has consequently elicited somewhat “stringent and draconian precautionary measures” by other countries in attempts at ensuring the virus doesn’t find its way into their borders. Such measures includes, alienating Africans, the imposition of travel bans on African nationals and refusing Africans entry into such countries. There have been reports that some countries have been unduly unfair and excessive to Africans at entry points. However, it should be known that effectively tackling the Ebola scourge should be embarked on from the source. To stop the spread of Ebola we need to go to its source, control it and stop its spread from the source. The latest figures from the WHO shows that this is far from happening. The source here is the West African countries of Guinea, Liberia and Sierra Leone.

The tragedy of Ebola is that we know how to tackle the disease, and with the right resources, information and on-the-ground support, this disease can be “nipped at its bud”. The Ebola outbreak in West Africa is already a global threat to public health and it’s vital that the international community remains at the forefront of responding to the epidemic. Even so, without mass mobilization of the world to support the affected countries in West Africa, it will be impossible to get this disease quickly under control, and the world will have to live with the threat of Ebola for a lot longer than necessary.

The general international response has up to this moment been slower than the rate of transmission of the disease. This slower-than-the-virus response has got to change. The acceleration of the translation of commitment to physical facts on the ground is what is urgently needed now. Commitments on paper and commitments during meetings are good, but commitments as physical facts on the ground are best. The international community needs to step up to the plate and deliver additional resources, not just money, but trained medical and clinical personnel to lead efforts on the ground.

To prevent what is currently a crisis from becoming a catastrophe, effectively tackling the Ebola epidemic in West Africa will involve building of “Ebola hospitals” in affected countries, consisting of treatment centres and an Ebola Training Academy. Also, replicating the Nigerian experience in curbing the spread of Ebola by effectively utilizing more aggressive and consistent public awareness campaigns, which yielded positive results and tracking all possibly infected individuals, who came in contact with the primary carrier of the disease; quarantining, observing and treating them. Thus, Nigeria was able to effectively halt the spread of the virus, which claimed 8 lives as reports suggest, the lowest when compared to the other affected West African countries. Notably though, kudos needs to be given to the Lagos state government. The success story of Ebola in Nigeria should be duly attributed to the fact that its first point of entry into Nigeria was at a state where the structure of governance was professional and organized. The Lagos government, in collaboration with the Federal government effectively took control when it was announced that a Liberian, Patrick Sawyer, coming into the country tested positive to the virus.

There’s every possibility that, had the late Sawyer come into Nigeria via another state, perhaps we would be singing a bitter tune. An example is the continuous and lingering Polio cases (already eradicated in most countries) that still exist in some parts of the country. Furthermore, the provision of technical assistance by international health organizations, through the deployment of multidisciplinary team of experts involved in a range of outbreak response activities such as surveillance, communication and social mobilization, infection control, logistics, data management, is needed in combating this epidemic.

The direst need in West Africa and the affected countries is for doctors and nurses. A large number of health care workers have being infected in this outbreak and majority of them have died as a result. The other need is for hospital beds, as the most affected countries are short of beds (according to the WHO Liberia needs 2300, Sierra Leone nearly 900 and Guinea 50). Without the hospital beds, infected patients are turned away- back into their communities, thus infecting others.

Hazmat suits should be made available for health care workers and West African countries should temporarily close their borders to affected countries, until such a time the epidemic can be controlled. In addition, albeit there have only been a handful of Ebola cases spreading beyond West Africa, governments around the world should ramp-up precautionary measures. Temperature screenings at airports should be introduced at all points of entry and exit in all countries.

Ultimately, the world needs to know that to get ahead of this disease, we have to collectively rise to the challenge. We can collectively contain it and beat it. We know how to do this; it may sound a little complicated but it is doable. It just requires a large focus of resource and effort to deliver it. All hands must be on deck and the focus must be one in order to ensure the eradication of Ebola right from its very source.